Analysis of diagnosis and treatment of recurrent vulvovaginal candidiasis(RVVC) in 69 cases

Objective To investigate the appropriate therapy of treating recurrent vulvovaginal candidiasis(RVVC).Methods Individual consolidated and maintenance therapy were chosen according to fungal culture of vaginal secretion and antifungal drug sensitivity per month as one therapy duration.Drugs were used orally and vaginally together to consolidate the therapy.Oral drugs were itroconazole(0.1,bid for 5days) or ketoconazole(0.2,bid for 5days) or fluconazole(0.15 for one time or 0.15 qw after 0.15 q3d for 2 times).Nystatin(400 000 unit qn for 7 days)or clotrimazole(0.1 qn for 7 days) or clotrimazole(0.5 qw) or amphotericin B(0.01qn for 6days) was vaginally used.The therapy was continued for 2 to 10 therapy durations after the symptoms disappeared with negative fungal culture.Results(1)The incidence of RVVC was 4.4% that of VVC,(2)Among 69 cases of RVVC,C.albicans was mostly detected(73.9%),C.glabrata was 21.7%.(3)The susceptivity to candidas of oral agents revealed that the sensitive rate of ketoconazole,fluconazole,itroconazole and terbinafine were respectively 94.2%,75.4%,62.3% and 43.5%.As for vaginal agents,nystatin and amphotericin B were 100% sensitive,clotrimazole was 94.2% sensitive,miconazole was 53.6% sensitive.(4)The effective rate of individual strengthening and solid therapy was 91.3%,the remote cure rate after discontinuing for 3 months,6 months and 12 months was respectively 81.2%,73.9% and 69.6%,respectively.Conclusion The predominant pathogen in RVVC is C.albicans.The effective measures to cure RVVC are to choose sensitive drugs for individual consolidated and maintenance therapy.